841 NE 95 Sturvey%of tn'Block
, ,1,;
A bcordrng to the PIatthereof? recorded rn Plat Book f %Page the Pubiic,Records of Dade County Florid
Subject4o:- -811 rest "r•rctions reserva:trons:easements and Rrght of Vda- V;'Record
Date
Si
Owner's Address
ctot
Legal Description pp�� {� 1
/ Tenant 'CkdAk YC c}" l °CIA ‘'6&J - l q ` ) U Master Permit #
\\ (� �� S� Phone 0 No a.
Contracting Co. 9 / NJS r.0-100
Qualifier V" >,/2 - ..S / ~S
State # Municipal # „1 ZOO C' Competency # ,il - Z o v o Ins. Co. fir 2 Z -713 a
Architect/Engineer — Address
Bonding Company Address
Mortgagor Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
PPC k-oNT Tc g0
WORK DESCRIPTION
/2.4 I/ - f` /P C■L ,A r,- --. • F /ZUiVT ,fin, « a " z-A07 j,' / 19s•94 T-
Square Ft. 8s) Estimated Cost (value)
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING,
CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable
laws regulating construction and zoning. Furthermore, I authorize the above -named contractor to do the work stated.
ture o
r
d/or C
- - - -- — - ❑;icy?::
do Presi DYSJ V$kat6R
NOTARY PUBLIC STATE OF FLORIDA
COMMISSION NO. CC714103
MY COMMISSION EXP. MAR. 1
Notary as o Owner and/or C
My Commission Expires:
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
Job Address $cq n et 6 CT Tax Folio
Historically Designated: Yes No
APPROVED:
Zoning Building
Mechanical Plumbing
President ••
otary as to
My Commiss
FEES: PERMIT 4 RADON C.C.F.__4 0 NOTARY
ontrac orb ! `^* ,: 1 0»t11
a fBLIC STATE OF FLORIDA
COMMISSION NO. CC714103
MY COM' ' IS61ON EXP. MAR. 12662
Electrical
Address /030 w ‘-• /a/7749 J13 r- •
SS# - Phone 305 b 57'9 7
6/2 a
of Contractor or Owner- Builder " Date
4 /.m $ —�� -ooy -
Date
9
BOND 3e
TOTAL DUE 3
Engineering